As war begins in Iraq, expert says talk, play and routine are important
for children to cope

By Sarah Yang, Media Relations |
20 March 2003

BERKELEY – With "No War" signs
in neighborhood windows, protesters on city streets and televised
images of soldiers in combat, children can't help but notice
the war in Iraq. At home and at school, many are asking questions
about war and picking up on adults' own anxieties and fears.

"The kinds of events we're now experiencing as a nation and
society potentially affect all or most kids," said W. Thomas
Boyce, MD, professor of epidemiology and child development at
the University of California, Berkeley, School of Public Health.

"There's not much in the way of concern, anxiety or fearfulness
on the part of the parents that can actually be hidden from
young children," he added.

Boyce emphasizes the importance of communication between parents
and children to help cope with stress. Parents should be available
to listen to and reassure their children, and to answer their
questions simply and honestly, said Boyce, who has 25 years
of clinical experience in developmental pediatrics, 10 of them
at UC San Francisco as head of the Division of Developmental
and Behavioral Pediatrics.

While everyday life can be fraught with such concerns as financial
security or school performance, Boyce said exceptional events,
such as a devastating earthquake or war, present salient stresses
for children.

Depending upon the developmental stage of the child, normal
reactions range from temporary regressive behaviors, such as
a loss of toilet training for toddlers, to greater separation
fears for preschoolers, said Boyce. Older kids in primary school
may complain of body aches, have nightmares, and experience
a transient decline in school performance.

Such symptoms were quite common in the aftermath of the 1989
Loma Prieta earthquake, and it's important for parents to understand
that such behaviors are normal coping mechanisms that typically
pass with time, said Boyce.

"Under these kinds of conditions, kids need a sort of predictable
world that is filled with people they know they can depend on
and who care about them," said Boyce. To the extent possible,
he said, parents should try to maintain routine and structure
for a child.

He also noted that parents need not discontinue daycare for
children going through separation anxiety, but can stay a bit
longer at the point of separation to ease the transition into
school.

"In any kind of event like this, the single most important
thing parents can do is be present and available and in contact
with their kids," he said. "And hold them. That physical presence
of the parent and the parent's availability for questions create
security for the child."

Parents and teachers may also notice children incorporating
aspects of war into their play, which is another common strategy
kids use to cope with the world around them, said Boyce.

Military families face special concerns as troops deployed
begin to battle. What can parents do when a child asks about
a close relative or family friend who was sent to war?

"I often tell parents to lead with the question, not with the
answers," said Boyce. "Don't assume that the question is what
you think it's about. Ask for more specifics from the child."

For instance, a child asking about a father deployed overseas
may actually be wondering what his parent's daily life will
be like, not whether he will be attacked with chemical or biological
weapons.

"If the child goes on to ask specifically about the family
member's safety, an honest answer can include reassurances that
everything we know to do is being done to protect this person
we love," said Boyce.

At UC Berkeley, Boyce continues his research into how children
react to stress. He has found in studies that there is a subset
of children - as many as one in five - who are exceptionally
sensitive to adversity and stress.

If a child appears to be unusually obsessed with war or experiences
inconsolable anxiety, Boyce recommends that parents seek help
from an expert such as a pediatrician or child psychiatrist.

To help children deal with stress, Boyce developed the following
tips for parents and caretakers:

Be present and available. Talk, listen and reassure.

Provide simple, direct answers to questions. Be honest.

Touch your kids. Holding and physical contact helps.

Maintain routines. Stick with regular bedtimes, mealtimes,
etc.

Understand developmental differences. Reactions differ depending
upon the developmental age of the child.

Allow stress-related play, which is one of the principal
methods of coping for a child.

Set a good example for coping methods. Pace yourself, divide
tasks into manageable pieces, exercise and become involved
in extracurricular activities.

Seek professional help when needed. Pediatricians, child
psychiatrists, social workers and child psychologists are
good resources.